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Drugs Used to Treat Autism

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Updated March 03, 2009

Can Drugs Cure Autism?:

You've read that there is no known medical cure for autism -- yet your doctor is prescribing medication. What's that about? The answer is simple. Your doctor is not treating autism: He is treating specific symptoms of autism. Often, when symptoms are treated, people with autism are better able to learn, communicate and generally connect with others.

Which Symptoms of Autism Can be Treated with Drugs?:

Not everyone with an autism spectrum disorder has the same symptoms, and not all symptoms can be treated with pharmaceuticals. Most often, when drugs are prescribed for people with autism, they are intended to address specific symptoms including behavioral issues, anxiety or depression, mood swings (bipolar disorder), obsessive compulsive disorder, attentional issues and hyperactivity.

Treating Anxiety and Depression. :

Selective serotonin reuptake inhibitors (SSRIs) are prescribed for anxiety, depression, and/or obsessive-compulsive disorder. Of these only Prozac has been approved by the FDA for both OCD and depression in children age 7 and older. Three that were approved for OCD are Luvox, age 8 and older; Zoloft, age 6 and older; and Anafranil, age 10 and older. Wellbutrin is an antidepressant that works differently from the SSRI class of antidepresants.

FDA Warning Regarding SSRI Drugs:

The FDA has issued an advisory to patients, families, and health professionals to closely monitor adults and children taking antidepressants for signs of suicide. This is especially important at the beginning of treatment or when doses are changed.

Treating Behavioral Problems :

Many autistic children have significant behavioral problems. Some can be managed by non-pharmaceutical treatments such as ABA, Floortime, etc. But when behaviors are out of control or dangerous, it may be time to consider antipsychotic medications. These work by reducing the activity in the brain of the neurotransmitter dopamine.

Older Anti-Psychotic Medications:

Older antipsychotic medications such as haloperidol (Haldol), thioridazine, fluphenazine, and chlorpromazine, haloperidol may be effective in treating serious behavioral problems. But all, including haloperidol, can have serious side effects such as sedation, muscle stiffness, and abnormal movements.

Newer Anti-Psychotic Medications:

Some of the newer "atypical" antipsychotics may be a better choice, particularly for children. Tests are in their early stages, though: No one has seen the long-term effects of atypical antipsychotics on autistic children. Of these drugs, Risperdone, Zyprexa and Geodon are the most promising. Clonidine, an antihypertensive,is sometimes prescribed for impulsiveness, aggression or anxiety.

Treating Seizures:

One in four people with ASD also have a seizure disorder. usually they are treated with anticonvulsants such as Tegretol, Lamictal, Topamax or Depakote. The level of the medication in the blood should be monitored carefully and adjusted so that the least amount possible is used to be effective. Although medication usually reduces the number of seizures, it cannot always eliminate them.

Treating Inattention and Hyperactivity:

Stimulant medications such as Ritalin and Concerta, used safely and effectively in persons with attention deficit hyperactivity disorder, have also been prescribed for children with autism. These medications may decrease impulsivity and hyperactivity in some children, especially those higher functioning children. Adderall is a stimulant, and is often used in the same way as ritalin or concerta to help with attention, focus and behavior issues.

Assessing Drug Options:

All pharmaceuticals described in this article have the potential for side effects. Some, when prescribed for autism, are prescribed "off label" (that is, for purposes other than that for which they were approved). That means that no pharmaceutical intervention comes without risk.

Because of the risk of any pharmaceutical intervention, it makes sense to use drugs only if and when symptoms are severe or uncontrollable by other means. Even then, it's critically important that you consult a medical doctor with experience in autism (and, if appropriate, pediatrics). Be sure that you leave the doctor with specific information about potential side effects. Ask your doctor whether any of these side effects could be dangerous, and be sure you know what to do if any problems arise. Make a follow-up appointment, too so your doctor can assess the success of the treatment and recommend any changes to the dosage.

Sources:

Strock, Margaret (2004). "Spectrum Disorders (Pervasive Developmental Disorders." NIH Publication No. NIH-04-5511, National Institute of Mental Health, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, 40 pp.

Hollander E. Phillips A. Chaplin W. Zagursky K. Novotny S. Wasserman S. et al. (2005. A placebo controlled crossover trial of liquid fluoxetine on repetitive behaviors in childhood and adolescent autism. Neuropsychopharmacology. 30, 582-589.

McCracken, J. T., McGough, J., Shah, B., Cronin, P., Hong, D., Aman, M. G., et al. (2002). Risperidone in children with autism and serious behavior problems. The New England Journal of Medicine, 347, 314-321. Research Units on Pediatric Psychopharmacology Autism Network (2005). Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Archives of General Psychiatry, 62, 1266-1274.

Association for Science in Autism Treatment Website. Copyright 2006.

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